Board of Governors Meeting Minutes December 13, 2017 L.A. Care Health Plan, 1055 West 7 th Street, Los Angeles, CA 90017 ECAC Members RCAC Members/Public L.A. Care Board of Governors/Staff María Adela Guadarrama, RCAC 1 Chair Ana Rodriguez, RCAC 2 Chair Cynthia Conteas-Wood, RCAC 3 Chair, ECAC Vice-Chair Michael Shelton, RCAC 4 Chair Maria Sanchez, RCAC 5 Chair * Andria McFerson, RCAC 6 Chair Fátima Vázquez, RCAC 7 Chair Maria Montes, RCAC 8 Chair Cristina Deh- Lee, RCAC 9 Chair, ECAC Chair Leticia Navarro, RCAC 10 Chair * Elsa Gervacio, RCAC 10 Vice-Chair Lluvia Salazar, RCAC 11 Chair * Elda Sevilla, At Large Member Deaka McClain, At Large Member Demetria Saffore, CCI Area 1 Chair Wilma Ballew, CCI Area 2 Chair Brenda White, CCI Area 3 Chair Nesima Istrefi, CCI Area 4 Chair Amanda Calzada, RCAC 1 Maricruz Alvarez, RCAC 2 Estela Lara, RCAC 2 Maria Casarrubias, RCAC 4 Clotill Cleo Ray, RCAC 5 Maria Cruz, RCAC 9 Fresia Paz, RCAC 10 Marlene Paz, RCAC 10 Evangelina Candelario, RCAC 11 Nicole Fitzgerald, CCI Area 1 MaryJo Fernando, CCI Area 2 Joseph Airo, CCI Area 3 Eduardo Kogan, Interpreter Paula Alvira, Interpreter * Excused Absent ** Absent *** Via teleconference Hilda Pérez, Member, Board of Governors Layla Delgado-Gonzalez, Member Advocate, Board of Governors John Baackes, Chief Executive Officer, L.A. Care Jose Avila, Member Retention Unit, Member Services Department Malou Balones, Committee Liaison, Board Services Jennifer Carabali-Cunningham, Committee Liaison, Board Services Idalia De La Torre, Field Specialist Supervisor, CO&E Kristina Chung, Community Outreach Field Specialist, CO&E Auleria Eakins, Community Outreach Manager, CO&E Aaron Garcia, Member Retention Unit, Member Services Department Felicia Gray, Community Outreach Liaison, CO&E Laura Garcia, Health Promoter Liaison CO&E Hilda Herrera, Community Outreach Liaison CO&E Judy Hsieh Bigman, Senior Communication Specialist, Communication and Community Relations Susan Ma, CCI Field Specialist, Communication and Community Relations Linda Merkens, Manager, Board Services Nancy Molina, CCI Liaison, Communication and Community Relations Courtney Nicholas, Community Outreach Field Specialist, CO&E Francisco Oaxaca, Senior Director, Communication & Community Relations Jose Ricardo Rivas, Community Outreach Liaison CO&E Victor Rodriquez, Community Outreach Liaison CO&E Aileen Sanchez, Department Assistant, CO&E Martin Vicente, Community Outreach Field Specialist, CO&E Mariah Walton, CCI Field Specialist, Communication and Community Relations
AGENDA ITEM/PRESENTER CALL TO ORDER APPROVE MEETING AGENDA APPROVE MEETING MINUTES STANDING ITEMS ECAC CHAIR PERSON REPORT BOARD MEMBER REPORT MOTIONS / MAJOR DISCUSSIONS Cristina Deh-Lee, ECAC Chairperson, called the meeting to order at 10:06 a.m. Cynthia Conteas-Wood, RCAC 3 Chair, ECAC Vice-Chair, suggested that written question and responses be included in meeting minutes. Chair Deh-Lee reported that Cultural and Linguistic Services staff will not attend today s meeting. They will report at a future ECAC meeting. Andria McFerson, RCAC 6 Chair, asked why the future agenda items that were requested at last month s meeting are not on today s agenda. Idalia De La Torre, Field Specialist Supervisor, CO&E, responded that future agenda items will be covered in future meetings. The Agenda for today s meeting was approved as amended. Ms. Conteas-Wood noted that the minutes indicate that her absence was not excused, which it was as she notified her field specialist. Nesima Istrefi, CCI Area 4 Chair, noted that the minutes only state the women get breast cancer and it should include that men get breast cancer as well. The meeting minutes for November 8, 2017were approved as amended. There was no report. Hilda Pérez, Member, Board of Governors, thanked the following members who attended the December 7 Board of Governors meeting: RCAC 1 Maria Adela Guadarrama 2 Chun (Michael) Choe / Ana Rodriguez 3 4 Rachel Rose Luckey 5 Maria Sanchez 6 Irma Torres / Andria McFerson 7 Angelica Albarran / Fatima Vazquez ACTION TAKEN Approved. 15 AYES, (Ballew, Conteas- Wood, Deh-Lee, Gervacio, Guardarrama, Istrefi, McClain, McFerson, Montes, Rodriguez, Saffore, Sevilla, Shelton, Vásquez and White). Approved. 15 AYES November 8, 2017 / Page 2 of 11
8 Maria Montes 9 Ichnarin Chea 10 Ruben Gavidia 11 Rosa Pastrana CCI Councils Area 1 Ernesto Sarmineto/ Dennis Moore/ Demetria Saffore Area 2 MaryJo Fernando/ Wilma Ballew Area 3 Brenda White Area 4 Nesima Itsrefi Layla Delgado-Gonzalez, Member Advocate, Board of Governors, reported the following: There were several public comments regarding the closure of the Clinic/IPA called DC3. We heard from Dr. Pedro Lopez, Roy Kaufman, Lolita Willis, Dr. Green, employees of DC3. We also heard from patients/family Ms. McMillan, Mr. Derrick, Ms. Allen, Soquil Rice, Mr. Pinkerman, Steven Canyon, Felix and Barbara Sutherland. All supplications to keep a contract with DC3 and L.A. Care. Rachel Rose Luckey from RCAC 4 expressed difficulties with assistance in getting things approved for services needed and asked that more assistance be given to Ms. Monsoor and the department she works in. Dennis Moore and Demetria Saffore from the Antelope Valley both gave comments of gratitude. Ms. McFerson asked the question as to who she had to speak to regarding the Health Promotor program and getting more involved with the community. For 2018, board members can choose to donate their stipends. The 2 organizations designated to receive those funds will be the American Lung Association and Kurka's Children's Health Fund. Board Member Michael Rembis will no longer serve on the L.A. Care Board. Board Member Mark Gamble was voted as the Board's Treasurer. Richard Seidman, MD, Chief Medical Officer gave his report. He stated that they will ask about member experience and have a more robust survey as well as have a post visit survey. Both the pharmacies and the call center will be encouraging members to get their flu shot this season. A new program called E-Management will be able to assist PCP to get connected with mental health services to be able to treat or diagnose depression and anxiety faster. Terry Brown, Chief Human Resource Officer, stated that they will be expanding where an employee can file a report/complaint. In light of the recent media events regarding November 8, 2017 / Page 3 of 11
UPDATE FROM CHIEF EXECUTIVE OFFICER November 8, 2017 / Page 4 of 11 harassment they will be revising some policies and possible expanding their training not just to management but to all employees. Roland Palencia, Director Community Benefits gave a report regarding Brilliant Corners and the Board approved a motion to continue to fund the Community Health Incentives Fund (CHIF), another $10 million in the following year of 2018 which would include $4 million to further fund the Brilliant Corners Foundation to fund housing for homeless L.A. Care members. Ms. McFerson noted that during the Board meeting she asked for more involvement of the African American community for the Health Promoter program. Member Perez responded that new health promoter supervisor will help revamp the program, to be able to have more programs for all. Chair Deh-Lee asked for more information about E-Management. Member Perez suggested that the Board Members biographies be distributed to RCAC and CCI members so they may become familiar with the Board members. John Baackes, Chief Executive Officer, wished all Happy Holidays and a peaceful New Year. He reported: The proposal in the tax bill to eliminate the mandate for people to have health insurance has been reported that the House and the Senate, and have reached a compromise. They will be announcing the bill soon. If that mandatemc bought it other than the fact that they would have had to pay a penalty. Having the mandate in the Affordable Care Act that meant people who went into these exchanges could be entitled to a subsidy. The mandate and the subsidy encouraged younger and healthy people into the pool which is what is bringing the price down. That is very threatening. The Child Health Insurance Program (CHIP) has yet to be refunded and it ran out of funds October 1. California has embedded CHIP within Cal MediConnect so it is very difficult to take it out. California also has a maintenance of effort requirement so if it does not get funded, the State has to figure out a way to come up with the money. There is no immediate danger in California to anyone losing coverage because the CHIP financing has not happened yet. It appears like that it would ultimately be funded and that will create problems in other states that have ran out of money. There was a single payer bill adopted in the Senate that is going over to the assembly. A single payer s system will eliminate the entire structure of commercial insures and public entities like L.A. Care. No one believes that it would get adopted in California because of the price tag attached to it. The DC3 Clinic is operated by a medical group that L.A. Care contract with called EHS. L.A. Care have recently terminated EHS from our network because of fraud. L.A. Care does not tolerate fraud. The EHS medical group represented 696 physicians, 92% of the primary care
COMMUNICATION AND COMMUNITY RELATIONS UPDATE physicians participate in other medical groups. The elimination of EHS from L.A. Care s network will have minimal impact on people. If there is a physician that does not participate in another group, L.A. Care will offer them a direct contract. L.A. Care is waiting for a response from EHS about contracting directly the DC3 clinic. L.A. Care will find a solution to be able to keep the clinic. Mr. Baackes will provide ECAC with a thorough explanation of the complexity of the contract arrangements in place at future meetings. Mr. Baackes shared that he will be discussing having a suggestion box at doctors offices even though it is not a requirement and it is up to the physician s discretion of the physician s office Ms. Conteas-Wood shared that at the USC has an electronic suggestion box. Francisco Oaxaca, Senior Director of Communications and Community Relations, reported: Work on the new L.A. Care Family Resource Center (FRC)in East L.A. has started. Staff is currently reviewing the final design of the inside of the center. The search for an FRC location in the RCAC 4 area is in process. The Consumer Advisory Committee (CAC) Member Fall Conference is on December 15. Staff is looking forward to bringing together all CAC members to discuss the goals and objectives for the coming year, how to work together to improve the health of the community, and to acknowledge the accomplishments in 2017. Mr. Oaxaca encouraged those who have RSVP d to conference and if their transportation needs have changed, to communicate changed with their CO&E or CCI Team staff. After a third round of discussions across all the RCACs and CCI Councils, a motion is on today s ECAC agenda to approve the revisions to the Operating Rules. A great amount of time was spent on each RCAC and CCI Council agenda over the past two months getting input from all the members. All RCACs and CCI Councils voted YES to approving all the revisions to the Operating Rules, some as presented and others with suggested amendments. Staff will review the feedback and recommendations during that agenda item. Mr. Oaxaca recognize Ms. Wilma Ballew, appointed by County Supervisor Sheila Kuehl to serve on the Personal Assistance Services Council (PASC) Board. The PASC organization is the public authority for In-Home Supportive Services (IHSS) in Los Angeles County. This gives L.A. Care two CAC members on the PASC board. Ms. Ballew joins another RCAC 3 Vice-Chair, Maggie Belton on the PASC board. Ms. McFerson stated the need for more participation from the Health Promoters in the community. In Inglewood there has been no participation in the past six months. Mr. Oaxaca responded that there has been participation in all communities in the past six months. The program is going to go through a complete restructure and the new program will be able to November 8, 2017 / Page 5 of 11
customize programs to fit each community s needs. Each program at the FRCs will have a different curriculum to be able to provide the best services to each community. The Health Promoters will eventually be fully integrated at the FRCs. There will be different ways for individuals to participate. November 8, 2017 / Page 6 of 11 Member Perez shared that in formal documents it mentions CAC, even though the Operating Rules that includes adopting that name has not yet been voted on by ECAC. Deaka McClain, At Large Member, shared that she agrees to changing the name from RCAC and CCI Council to CAC as all RCACs and CCI Council members should feel that they are all part of the same group. Brenda White, CCI Area 3 Chair, shared that the Inglewood FRC has a lot of activity. Ms. Ballew, shared that she attended the Inglewood FRC and it was very active and diverse. Dr. Seidman joined the meeting and reported that e-management has been implemented with 159 providers. Over 10,000 behavioral health screenings were conducted and 102 edialogues completed with 94% of closed cases managed in primary care medical homes. E-Management will screen for anxiety, depression, and substance. Some screening tools can be used to selfreport and staff may assist if needed. The results fall into low, mild and high risk. Some risk will recommend a referral. Maria Sanchez, RCAC 5 Chair, asked if primary doctors are capable of giving prescriptions as a psychiatrist. Dr. Seidman responded that it all depends on the doctor. They should all be able to screen, diagnose and treat the patient. However, they might not all feel comfortable treating the patient. Elsa Gervacio, RCAC 10 Vice-Chair, shared that she asked her primary care doctor for a referral to a physiatrist and they told her that she had to contact L.A. Care. Dr. Seidman responded that individuals do not need a referral to receive mental health services. Member Perez asked for more information about the CAHPS Member Experience Survey. Dr. Seidman responded that they are done to a sample. They are 60 questions on experience of the last six months with their health plan. The past year L.A. Care scored 3.5 out of 13 points. In the past L.A. Care have scored up to 6.5 and hopes to get there again. Estela Lara, RCAC 2, shared that she received the survey and indicated she will not be able to give the plan a 10. There needs to be improvements on the wait times for appointments and attitudes of clinic staff. Dr. Seidman thanked Ms. Lara and noted that L.A. Care needs honest feedback so L.A. Care can approve. Dr. Seidman shared that a report card was developed for Independent Physician Associations that included member experience and offer a financial incentive.
GLOBAL MEMBER ISSUES OLD BUSINESS APPROVAL OF REVISIONS TO THE OPERATING RULES FOR THE COMMUNITY ADVISORY COMMITTEES AND EXECUTIVE COMMUNITY ADVISORY COMMITTEE OF L.A. CARE HEALTH PLAN November 8, 2017 / Page 7 of 11 Ms. McFerson shared the social workers at hospitals need to get trained on L.A. Care services. Auleria Eakins, Community Outreach Manager, CO&E, responded that she spoke to an employee from the County hospital who said that they will reach out to L.A. Care after the holidays to work together in updating the information they have for social workers regarding L.A. Care. Maria Montes, RCAC 8 Chair, shared that members did not know that pap smears are done every three years. They have expressed that the test should be conducted every year. Ms. De La Torre responded that she will touch base with the medical team. Ms. McClain shared that if there is no family history of cancer the test is provided every three years. Ms. Istrefi suggested members to ask the doctor to conduct the test on them if they feel some sort of discomfort. Judy Hsieh Bigman, Senior Communications Specialist, Communications and Community Relations, reported on the Operating Rule feedback that was provided from the RCAC and CCI Councils. Add CCI Councils throughout Operating Rules No Dual Membership Add New Requirements for New Members (Provisional Members) Clarify membership eligibility check (New Members and Recertification) Requirement to sign Code of Conduct and Standards of Behavior All RCACs and CCI Councils voted yes to approve adding CCI Councils to Operating Rules and voted yes to have no dual membership on the consumer advisory committeses. Additions feedback: o RCAC 4 suggested Consumer should be replaced with Member or Community All RCACs and CCI Councils voted yes to approve the new requirements for new members (provisional members). All CCI Councils voted Yes to approve the clarification of membership eligibility checks (New Members and Recertification, as submitted. RCACs 1, 2, 3, 4, 5, 7, 8, 9, 10, 11 voted to amend the revisions by keeping the recertification grace period at 60 days, rather than the proposed 30 days. All RCACs and CCI Councils voted Yes to approve the requirement to sign the Code of Conduct and Standards of Behavior. ECA-100.1217 Motion to approve revisions to the consumer advisory Operating Rules, as attached. Motion Amendment Approved. 14 AYES, (Ballew, Conteas- Wood, Deh-Lee, Gervacio, Guardarrama, Istrefi, McClain, Montes, Rodriguez, Saffore,
2017 ORAL HEALTH INITIATIVE (OHI) PARTNERSHIP NEW BUSINESS I-SPEAK TRAINING November 8, 2017 / Page 8 of 11 To approve the revisions to the Consumer Advisory Committee Operating Rules with the exception of the member recertification grace period; keeping the current 60-day grace period in the Operating Rules for the recertification of CAC members. Martin Vicente, Community Outreach Field Specialist, CO&E, presented 2017 Oral Health Initiative OHI) Partnership. Increase Access to Dental Health for vulnerable low income residents Raise awareness of community dental Health services and resources Provide education on preventive dental care Opportunity to received up to $5,000 Received a total of 28 applications and 17 were funded Applications were reviewed by CAC adhoc committees Required to be a not-for profit entity Services were provided in L.A. County OHI activites included the following: o Health resource fairs o Back to school wellness event o Festivals o Community Based Organization open houses o Community Partnership Events o Dental screenings o Information and resources o Oral Health exams o Dental Health presentations o Dental kits Ms. Eakins reported: ISA program seeks L.A. Care advisory members who desire to learn and advance advocacy for Medicaid and Medicare members. Who can participate? CAC members who are not currently appointed as Chair, Vice- Chair or At-Large Member of their Community Advisory Committee (RCAC or CCI). What is the commitment? Want to learn and help L.A. Care understand the member perspective related to health care. Be able to participate in six (6) monthly trainings: o January 12, 2018 Sevilla, Shelton, Vásquez and White). 1 Nay ( McFerson).
ECAC CHAIR AND VICE CHAIR NOMINATIONS/ELE CTIONS CCI AREA 1 MOTIONS TO ECAC o February 9, 2018 o March 9, 2018 o April 6, 2018 o TBD o TBD Be able for possible travel to Sacramento for legislative office visits. Able to complete a short application stating why you desire to participate in the program. What type of things to learn? Managed Care 101 The basics of health data Advocacy, Resources and Health Equity Using Your Voice and effective communication Technology and Health Effective Outreach Strategies The deadline to submit the application is on Wednesday, January 3, 2018. Ms. Conteas-Wood asked if all RCAC members know about this opportunity. Ms. Eakins responded that staff is doing their best trying to get the word out. Mary Jo Fernandez shared that she has discussed with her field specialist that she wanted to participate in the program. Ms. McFerson thanked staff for this program as all members can participate. Member Perez suggested to include the Americans with Disabilities Act in the discussion. Ms. Eakins responded that this is a pilot program and depending how it goes, L.A. Care will be able to include different topics in the future. Ms. De La Torre reported that this month nominations will be open for ECAC Chair and Vice Chair. The deadline to nominate someone is on January 5. Current Chair and Vice Chair are eligible to run again. Demetria Saffore, CCI Area 1 Chair, brought to the table the following motions: ECA.A-1217 Motion to request that L.A. Care staff investigates and report back their findings on Antelope Valley Hospital s emergency room practices, including: Staff training on proper patient care, such as providing discharge, Durable Medical Equipment (DME) use, and medication instructions to patients; HIPPA compliance, and proper usage of personal November 8, 2017 / Page 9 of 11
FUTURE AGENDA ITEMS PUBLIC COMMENT protective equipment (PPE); and, their practice of referring emergency room patients to other hospitals. Amendment: Motion to request that L.A. Care staff investigates and report back their findings on Antelope Valley Hospital s emergency room practices, including but not limited to: Staff training on proper patient care, such as providing discharge, Durable Medical Equipment (DME) use, and medication instructions to patients; HIPPA compliance, and proper usage of personal protective equipment (PPE); and, their practice of referring emergency room patients to other hospitals. María Adela Guadarrama, RCAC 1 Chair, shared that her friend s daughter who was 11 years old passed away after getting refused to get treated three times at that hospital. Then they concluded that she had a virus, and in reality she had two tumors in her head. Ms. Ballew noted that the staff in that hospital should be getting investigated as it is a training hospital. Ms. Guadarrama noted that this is the only hospital in that area for pediatrics. Ms. McClain requested to add cultural events and events to celebrate Black History Month that is in February. Ms. Ballew requested for the Facility Site Review staff to attend a future ECAC meeting to provide information. Ms. McFerson requested work groups to increase community Health Promoter participation. Member Perez thanked all for another year of hard work. Thanked L.A. Care for allowing members to participate on the process of updating the Operating Rules. Ms. McClain suggested that it should state in writing that exceptions may be made to allow dual members. Ms. McFerson shared the the Health Promoter contract states I must that should be replaced with I agree. Maria Casarubia thanked all because two years ago she reported to the Committee that her daughter was getting bad treatment at her doctor s office and L.A. Care investigated and fixed the problem. Ms. Ballew thanked L.A. Care for all the training opportunities as if it would not had been for that she would have not been able to take on the new roll of being part of the PASC Board. November 8, 2017 / Page 10 of 11
ADJOURNMENT Mr. Oaxaca thanked all for a fantastic year and all the input. Wished all a peaceful and healthy New Year. Chair Deh-Lee thanked all for their support and wished all a Happy Holidays The meeting adjourned at 1:04 pm. RESPECTFULLY SUBMITTED BY: APPROVED BY Jennifer Carabali, Committee Liaison, Board Services Linda Merkens, Manager, Board Services Christina Deh-Lee, ECAC Chair Date November 8, 2017 / Page 11 of 11